A Long-Surviving Case of Resected Rectal Metastasis After Sursrery for Advanced Gastric Cancer

概要

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A 44-year-woman was admitted to our hospital with discomfort in the epigastric area. Preoperative examinations revealed a 9.0x9.0 cm, Borrmann IV type tumor extending from the anterior to the posterior wall of the gastric body without distant metastases. A total gastrectomy with pancreato-splenectomy and regional lymph node dissection was performed. Histologically, the tumor consisted of an adenocarcinoma with mucin. Final findings were PO, HO, t4, n2 and Stage Illb. Adjuvant chemotherapy was performed with a continuous intravenous infusion of 5FU (1500 mg/body) and CDDP (10 mg/body). Nineteen months after the operation, her cancer recurred with peritoneal metastases which were diagnosed by a biopsy during a proctoscopy of the rectum and by elevated levels of the serum tumor marker carbohydrate antigen (CA19-9). An abdomino-perineal resection with oophorectomy and lymph node dissection was performed for the recurrent gastric cancer. The patient survived for three years postoperatively without any sign of progressive disease. However, she eventually died of peritoneal metastases. Macroscopic curative dissectin of advanced gastric cancer of peritoneal metastases and then adjuvant combination chemotherapy should be considered effectively.
愛知医科大学の論文
2005-06-10